环孢霉素A联合大剂量糖皮质激素治疗重度活动性TAO的临床疗效与安全性分析

发布时间：2018-03-03 07:25

本文选题：重度活动性甲状腺相关眼病　切入点：环孢霉素A　出处：《广西医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的探讨环孢霉素A联合大剂量糖皮质激素治疗重度活动性甲状腺相关眼病(thyroid-associated ophthalmopathy, TAO)的临床疗效与安全性。方法对2010-2012年在广西医科大学第一附属医院眼科确诊为重度活动性TAO,经单纯糖皮质激素治疗效果不佳的患者16例,采用环孢霉素A联合大剂量糖皮质激素治疗。观察治疗前后患者的视力、临床活动性积分、眼压、视觉电生理、色觉、眼部症状改善情况及并发症发生情况。结果经治疗后,患者临床活动性积分明显下降,治疗前后比较,差异有统计学意义(p0.05)；视力明显提高,治疗前后比较,差异有统计学意义(p0.05)；大部分患者的眼压、视觉电生理、色觉、结膜充血、眼睑肿胀明显好转或消失,且全身并发症少。结论对单纯大剂量糖皮质激素治疗效果不佳的重度活动性TAO患者,加用环孢霉素A治疗,可有效的控制患者免疫性炎症,降低患者的临床活动性积分、提高视力且并发症少,是安全有效的治疗方法。
[Abstract]:Objective to investigate the clinical efficacy and safety of cyclosporine A (cyclosporine A) combined with high dose glucocorticoid in the treatment of severe active thyroid associated ophthalmopathy (TAOO). Methods Sixteen patients diagnosed as severe active TAO in the first affiliated Hospital of Guangxi Medical University from 2010 to 2012 were treated with glucocorticoid alone. The visual acuity, clinical activity score, intraocular pressure, visual electrophysiology, color perception, ocular symptom improvement and complications were observed before and after treatment with cyclosporine A and high dose glucocorticoid. Results after treatment, the clinical activity score of the patients decreased significantly, the difference was statistically significant before and after treatment, the visual acuity was significantly improved, the difference was statistically significant before and after treatment, the majority of patients had intraocular pressure, visual electrophysiology, and visual electrophysiology. Color vision, conjunctival hyperemia, eyelid swelling significantly improved or disappeared, and less systemic complications. Conclusion for the patients with severe active TAO who are not well treated by high dose glucocorticoid alone, the addition of cyclosporine A can effectively control the immune inflammation of the patients, reduce the clinical activity score, improve the visual acuity and have fewer complications. Is a safe and effective treatment.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R581;R771.3

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